Towards Lab-Free Tuberculosis Diagnosis

Tuberculosis (TB), fuelled in part by the HIV epidemic, remains a major challenge to public health. Despite the potential for most cases of tuberculosis to be curable, TB causes around two million deaths per annum. These deaths are in part due to late or missed diagnosis. Improving the performance of diagnostics and their availability are key to reducing global morbidity and mortality.

Despite the recognised importance of diagnostics, funding for TB diagnostics remains inadequate. Recent years have seen progress in TB diagnostics with attention focused most recently on the Xpert MTB/RIF system. Despite this progress, there is still a lack of suitable, simple diagnostics for peripheral health centres or community-based diagnosis of TB.

This report provides an overview of the current state of science and research on TB diagnostics, as well as an assessment of resources such as specimen banks available for TB diagnostics research. It details some of the key roadblocks to the development of a simple point-of-care test for TB suitable for peripheral health centres, such as the need for novel biomarkers that can be used to detect TB and can form the basis of test design; the lack of specimen repositories to provide well-characterised samples for the validation of these biomarkers; and the need for technological breakthroughs in sample collection, processing and testing to improve quality of materials collected from the site of disease to enhance diagnostic accuracy.

Also available: Summary version of report (PDF)

A report by TAG, the TB/HIV Working Group of the Stop TB Partnership, Imperial College and the MSF Access Campaign